Pediatric vesicoureteral reflux guidelines panel summary report on the management of primary vesicoureteral reflux in children

Jack S. Elder, Craig A Peters, Billy S. Arant, David H. Ewalt, Charles E. Hawtrey, Richard S. Hurwitz, Thomas S. Parrott, Howard M. Snyder, Robert A. Weiss, Steven H. Woolf, Vic Hasselblad

Research output: Contribution to journalArticle

492 Citations (Scopus)

Abstract

Purpose: The American Urological Association convened the Pediatric Vesicoureteral Reflux Guidelines Panel to analyze the literature regarding available methods for treating vesicoureteral reflux diagnosed following a urinary tract infection in children and to make practice policy recommendations based on the treatment outcomes data insofar as the data permit. Materials and Methods: The panel searched the MEDLINE data base for all articles from 1965 to 1994 on vesicoureteral reflux and systematically analyzed outcomes data for 7 treatment alternatives: 1) intermittent antibiotic therapy, 2) bladder training, 3) continuous antibiotic prophylaxis, 4) antibiotic prophylaxis and bladder training, 5) antibiotic prophylaxis, anticholinergics and bladder training, 6) open surgical repair and 7) endoscopic repair. Key outcomes identified were probability of reflux resolution, likelihood of developing pyelonephritis and scarring, and possibility of complications of medical and surgical treatment. Results: Available outcomes data on the various treatment alternatives were summarized in tabular form and graphically, and the relative probabilities of possible outcomes were compared for each alternative. Treatment recommendations were based on scientific evidence and expert opinion. The panel concluded that only a few recommendations can be derived purely from scientific evidence of a beneficial effect on health outcomes. Conclusions: For most children the panel recommended continuous antibiotic prophylaxis as initial treatment. Surgery was recommended for children with persistent reflux and other indications, as specified in the document.

Original languageEnglish (US)
Pages (from-to)1846-1851
Number of pages6
JournalJournal of Urology
Volume157
Issue number5
DOIs
StatePublished - Jan 1 1997

Fingerprint

Vesico-Ureteral Reflux
Antibiotic Prophylaxis
Guidelines
Pediatrics
Urinary Bladder
Therapeutics
Pyelonephritis
Expert Testimony
Cholinergic Antagonists
Urinary Tract Infections
MEDLINE
Cicatrix
Databases
Anti-Bacterial Agents
Health

Keywords

  • bladder
  • kidney
  • outcome assessment (health care)
  • ureter
  • vesico-ureteral reflux

ASJC Scopus subject areas

  • Urology

Cite this

Pediatric vesicoureteral reflux guidelines panel summary report on the management of primary vesicoureteral reflux in children. / Elder, Jack S.; Peters, Craig A; Arant, Billy S.; Ewalt, David H.; Hawtrey, Charles E.; Hurwitz, Richard S.; Parrott, Thomas S.; Snyder, Howard M.; Weiss, Robert A.; Woolf, Steven H.; Hasselblad, Vic.

In: Journal of Urology, Vol. 157, No. 5, 01.01.1997, p. 1846-1851.

Research output: Contribution to journalArticle

Elder, JS, Peters, CA, Arant, BS, Ewalt, DH, Hawtrey, CE, Hurwitz, RS, Parrott, TS, Snyder, HM, Weiss, RA, Woolf, SH & Hasselblad, V 1997, 'Pediatric vesicoureteral reflux guidelines panel summary report on the management of primary vesicoureteral reflux in children', Journal of Urology, vol. 157, no. 5, pp. 1846-1851. https://doi.org/10.1016/S0022-5347(01)64882-1
Elder, Jack S. ; Peters, Craig A ; Arant, Billy S. ; Ewalt, David H. ; Hawtrey, Charles E. ; Hurwitz, Richard S. ; Parrott, Thomas S. ; Snyder, Howard M. ; Weiss, Robert A. ; Woolf, Steven H. ; Hasselblad, Vic. / Pediatric vesicoureteral reflux guidelines panel summary report on the management of primary vesicoureteral reflux in children. In: Journal of Urology. 1997 ; Vol. 157, No. 5. pp. 1846-1851.
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